The DDA Podcast
The DDA has created its own series of podcasts with information and analysis of dispensing doctor matters in conversation with DDA Board Members and invited guests.
The DDA Podcast
9. The rural voice in the UK parliament
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"It's the 'Golden hour' to engage with the new health secretary." That's the call to action from Suffolk Coastal MP and Chair of the Labour Rural Research Group Jenny Riddell-Carpenter in the latest episode of the DDA Podcast.
In this podcast, hear Riddell-Carpenter set out the implications of the change at the top of the Department of Health and Social Care, how rural GPs can be at the heart of Neighbourhood Health and why dispensing GPs are critical to that conversation.
Referenced in the podcast are:
LRRG inquiry: The Future of the Rural Economy
LRRG report: Understanding Rural Britain
LRRG report: Rural Poverty in Britain
DDA Manifesto: Addressing the Disparities: A manifesto for change
RSN campaign: Rural Fair Funding: The Final Settlement for Local Government Finance (Feb 2026)
Rural proofing, or lack of it, is a common complaint from dispensing GPs faced with at-scale NHS primary care policy that takes little account of the unique challenges of providing health services in rural areas. Today we're speaking to Jenny Riddell Carpenter, Member of Parliament for Suffolk Coastal, and one of Labour's most notable rural wall winners in the 2024 elections. And our topic for today is the rural voice in the UK Parliament. I'm Elsa Cahun, the DDA's communications officer, and this is the DDA podcast. Welcome, Jenny.
SPEAKER_00Hi, thanks for having me.
SPEAKER_01So the 2024 general election resulted in a landslide win for the Labour government, with some of the biggest majorities being overturned in our rural heartlands, such as South West Norfolk, South East Cornwall, and of course yours in Suffolk Coastal. So we have a number of new rural MPs in Westminster. How has this changed the reach of the rural voice in Parliament? Hugely.
SPEAKER_00We've got record numbers of rural Labour MPs at that 2024 general election. Rural MPs like myself, who not just represent rural constituencies like Suffolk Coastal, but represent constituencies that I grew up in that shaped me. And I'm obviously Labour. I have very strong Labour values, but I also have really rooted values in the community that I grew up in and have a real sense of pride in the constituency and what rural Britain gives, what it offers, and what it also needs from a government.
SPEAKER_01There's still quite an urban bias to the health department, though. Our new health secretary, James Murray's constituency, is in Ealing in London. Karen Smythe is Bristol. Only Stephen Kinnock has a partly rural constituency. Do you think the health department has the necessary rural expertise to understand rural issues?
SPEAKER_00Well, it's got a lot of rural MPs around it talking to it all the time. And many of those MPs that you've talked just of, though they represent urban constituencies now, they've many of them have grown up in rural areas and then moved to the cities and been shaped by that kind of history of the relationship they had with rural Britain. But you've got a lot of rural MPs like me that do a lot of work to advocate for rural Britain. And you can imagine that as soon as James Murray got announced as the new Secretary of State for Health, one of the first uh messages he got was from me as chair of the Labour Rural Research Group to say congratulations, and I've got a lot to talk to you about. So representing a certain type of constituency, I don't think, don't think at all, lends itself to not being able to hear the or understand the issues beyond the type of state that you represent.
SPEAKER_01So you mentioned there that you are chair of the Labour Rural Research Group. What does this aim to do and how important is health to its agenda?
SPEAKER_00As you can imagine, whenever you're new in a place or you kind of gather around people that have similar interests, similar backgrounds, etc. So we kind of came together not long after the general election and really wanted to work together as rural MPs to advocate for rural issues. And then something happened around the autumn budget time. We had a piece of policy that was brought along by Treasury on the farming tax, inheritance tax. And there was a group of Labour rural MPs, myself included, that had some real concerns about that policy and how it would the impact it would have locally in our rural constituencies, but also on the rural economy more widely. So we got together out of that kind of urgency. But what really became evident during that was that we'd come together on the back foot, trying to change a policy that we didn't particularly like or agree with. And we were very much on the back foot and we wanted to be on the front foot in the future and shaping policy, not fighting it from that back foot. There's a lot more about rural Britain, there's some huge, amazing opportunities that we've got going for us, but some some real systemic challenges that we have in terms of public services across the whole suite of public services are real challenges. So we didn't want to be seen as backbench farmers, we wanted to be seen as passionate Labour MPs delivering for rural Britain and living our values in that in that space. So we we pulled together a report. The report was looking at understanding rural Britain and looking at what was going on, what the kind of political breakup was, breakdown was, uh, looking at some of the key issues and really challenging government's perception of what rural Britain meant and what the issues were in rural Britain.
SPEAKER_01Were you a bit surprised by that decision on in on the farming inheritance tax because the rural vote was so important and so noteworthy for the general election?
SPEAKER_00A number of my rural colleagues were quite upset at the time. They had said publicly before the election they weren't going to do it. Um, and lots of my colleagues have talked about that the frustrations they had and going to farmers when we'd said publicly pre-election we weren't going to do it. And this isn't a criticism of Labour, to be fair, this is a criticism of all governments for many decades. It's just a failure to understand rural Britain and how it worked.
SPEAKER_01Even with all the new rural MPs, though, that's my point is that you know, where was the voice of all these new rural MPs who were so important to the election victory?
SPEAKER_00Well, let's be really clear the the voice of rural MPs under the last government wasn't there and hadn't been there for decades. So Liz Truss was a rural MP in South West Norfolk, one of the seats that you referenced in the introduction. She was the Prime Minister. Therese Coffee was my predecessor. And I wouldn't say that any of them were ardent advocates for rural Britain. In fact, many of them, many of the policies that they pushed out when they were Prime Minister and Deputy Prime Minister and in Secretary of State's roles were detrimental to rural Britain. So this has been a systemic issue. This has been a historic issue of MPs just failing to understand and failing to represent. It would be to misdiagnose the problem if you if we were to say that Labour MPs don't get rural Britain, because there's evidence that for decades the Tory government didn't get rural Britain and certainly didn't advocate for it. And that is why, fundamentally, people like me won our seats, because they had been constituents who have been let down by those incumbents for failing to advocate for it. This isn't a blue or red issue. This is just systemic failure for many years on this issue.
SPEAKER_01In your Understanding Rural Britain report, you mentioned health and housing priorities. Housing development has is a double-edged sword for dispensing doctors because as a population grows, their rights, their dispensing rights are undermined. And losing dispensing is obviously something that undermines the viability of a practice. Now you've got 54 dispensing GP practices in Suffolk. How will you look after the place of dispensing doctors and that rural dispensing GP service that they offer?
SPEAKER_00Yeah, I've had meetings with GP practices about this and met with dispensing doctors. There are a whole set of issues, and I'm very alive to them. And I've been communicating some of those challenges that have been raised directly back to me with the previous Secretary of State for Health, and I'll continue to do so for the new Secretary of Health, James Murray. It is an issue. But being able to put them when we're going through this transformation or transformation within the NHS and within health more generally, and there are key targets that need to be met, dispensing doctors absolutely need to be at the heart of that drive. Otherwise, we risk losing out, well, not just losing opportunity in rural areas, but actually seeing a worsening health issue if we don't make sure that the rural needs are at the heart of the NHS transformation programme.
SPEAKER_01So, how how might a group like yours go about doing that, supporting the place of dispensing doctors?
SPEAKER_00You mentioned the report. The next report that came after that was on tackling rural poverty. And in that report, there were a number of recommendations about prioritizing rural health in that NHS strategy, in the NHS transformation programme. And within that, there are a number of asks. Dispensing doctors will be a part of that conversation for us because obviously it's critical, it only affects rural areas and dispensing doctors focus. So, in that report that we've put out, we launched it about three or four months ago, and we've had many, many conversations with many departments. So it's a report that looks at cross-departmental challenges. It looks at housing, transport, health, education, and it talks about the rural penalty, the penalty that people pay to live in rural areas where often health outcomes are worse, life expectancy is often lower, everything costs significantly more. So that's a big part of the work that we're doing. And when you ask me how can dispensing how can dispensing doctors have a voice within that, it it continues to be part of our conversation that we have to be putting forward many solutions, of which one of them is tackling the challenges and bringing down the barriers that exist in rural Britain.
SPEAKER_01Obviously, we have the NHS 10-year health plan, and you've described it as having the potential to provide a step change for the health of rural people. I mean, we're sort of slightly disappointed by the NHS 10-year plan because there's only eight mentions of the word rural in 169 pages, and the case study given is of Whitstable in Kent of a practice of 45,000 patients, which is much bigger with better digital and transport connectivity than a typical rural practice would have. What progress are we likely to see from the 10-year plan or is imminent that we can tell rural GPs?
SPEAKER_00So it's worth just referencing again. I know we've mentioned it a few times, but we've obviously got a new Secretary of State now for health. And though nobody likes change because we need consistency, it does mean there is a new person leading from the top. And that's just that's just the reality. That's the context in which all departments work, is that reshuffles bring in new people. So we now have a new face leading that department. One of the things that we've been advocating for as LRRG within the health space is the neighbourhood health plan, I think is great and is transformative. So you are in a health desert in rural areas frequently, and I think these neighbourhood health plans could really transform how we deliver. If you look at the guidance for what was set out, it looks like it's describing a rural health strategy. It looks like it's saying take health out of this primary setting, the hospital setting, and put it in the communities, make it easier for people to access simpler services, simpler procedures, and put it back in the communities. Well I, when I read that, I thought that was it read like a rural manifesto, like a rural health manifesto. I have been disappointed that we haven't been able to get that front and centre of the rollout. Uh, but we have been pushing really hard for them to understand that we need this to work in rural Britain. And lots of the areas that already have hospitals don't need a health, in my view, don't need a community health centre a mile down a different road when we need those community health centres to go to places where rural Britain would be able to access it. So I'm I'm I always think in my constituency there's an incredible GP surgery in this place that I think of it as Sax London, and it's amazing, and it has such a high far reach. It sits on the A12, which is one of our key roads, is our key road running up the east coast of Suffolk. It has quite a wide catchment from mid-Suffol to East Suffolk, but also the road network allows it to have a north and south spread. It's got trap, it's got rail. It's unusual that it has a bus service as well, which in real areas is a real challenge to find. So it is perfectly situated. And it's the GP practice is doing outstanding work, and it is the obvious place where we should be locating health, our neighbourhood health centres and co-locating other services. Now, it probably won't surprise you that the story carries on that GP services, GP Practice is already doing a lot of that good work, it's already finding innovations, just needs a bit of support to get going to that next level. And what we don't need, in my view, is these health centres located in towns and cities where they already have.
SPEAKER_01But the fund the funding has to be right though for the GP services to be able to offer those services in a sustainable and future-proofed way. And dispensing is definitely an area that those GP services have, but which hasn't had its its funding change substantially since 2012. I mean, these are these are important practical issues to tackle, as well as the rhetoric of GP practices are in the right place to do this.
SPEAKER_00Yeah, no, I don't disagree.
SPEAKER_01So you also did a a report, uh, the future of the rural economy, which closed to comments in early May. It's brand new. Public services and access to opportunity were one of the areas that were covered in that report. Are there any early conclusions to be drawn?
SPEAKER_00Just undertaken some focus groups to understand some of their concerns about economic growth and what it means for them. But really, it's about harnessing the potential of rural Britain and making sure that the benefits are felt locally. So we know, I know, many of my colleagues know, that the government, this government or any government can't deliver growth without rural Britain. When we talk about transport infrastructure or energy, whether that's renewable or even otherwise, when we talk about the kind of big build programs that governments like to talk about, all of those would be delivered in rural areas. So we know that rural Britain is absolutely critical for any growth strategy of any government, but we also know so many of the opportunities don't then come to rural Britain, often overlooked. So the big focus of that report is right, how do we make sure that we harness growth? How do we make sure that we do growth that's right for rural Britain? But how do we also make sure that that is inclusive growth that benefits rural Britain, gives it the public services, the connectivity, the right funding as well, the right education opportunities, the right access to employment, the right housing approach, the right access to housing. How do we make sure that it's part of that growth and it feels the benefit of the seed it's sowing?
SPEAKER_01There's work to be done, certainly in the funding side of things, because I mean the Rural Services Network, for one, questioned the fairness for rural areas of the final settlement for local government finance that was published in the 9th of February. What comment do you make about their concerns about just the lack of emphasis on the need to finance rural areas properly?
SPEAKER_00I've obviously read their concerns. It's it's a mixed picture in how that final settlement concluded. There were some rural winners. So, for instance, Nottinghamshire, if you take out Nottingham from their equation, Nottinghamshire secured a 30% uplift, whereas Notting got Nottingham got 1%. So it's it's there are it's not across the board. So there was some good news in it, which started to look at where previous formulas hadn't taken into account the right things, but obviously it doesn't go far enough. And I'm I and my colleagues are calling to say, yes, some of that was welcomed, some of that needs to be applauded because actually no government's really tried to understand it. When they were bringing out that formula, they were really trying to get their heads around, right? How do we re-look at population sparsity? How do we re-look at poverty, deprivation, how do we recalibrate the calculator to make it fit for purpose? So I think they were asking the right questions when they were coming to reformatting that formula, and some of the stuff that came out of the sausage machine was good, some of it not quite so good, but there's also more opportunity to keep challenging and influencing that process.
SPEAKER_01Now we published ahead of the local elections a manifesto for dispensing practice, addressing the disparities, a manifesto for change. The key issues really, there are lots of technical parts to this, but the key issue is really that dispensing funding has not seen any significant change since 2012. That's obviously 14 years ago now, and inflation and price and costs have changed enormously since that time. Some of the quality incentive schemes that uh we have in dispensing practice haven't changed since their inception. And we also have the employer's national insurance contributions that were not covered for the dispensary team. Are these issues that the LRRG and your colleagues can take forward for us? Because this is something that's crucial to the sustainability of dispensing practice and the rural general practice service.
SPEAKER_00I think they're really important. We have, I alludes to what I was saying earlier, we have a rural penalty, everything is just more expensive in rural Britain, and we also have real challenges in delivering healthcare.
SPEAKER_01Is the Secretary of State listening though? Well He's been in place for two days. Yes, but um he takes forward a well-established manifesto, a well-established brief.
SPEAKER_00Uh but I think if you ask, is the Secretary of State listening? It's the wrong question to ask when they've been in for two days. I think the question is that you need to be asking everyone is there's a new face, get engaging with have you engaged with him and getting get engaging, get writing. This is a it's obviously not a blank slate. Like you said, he's he's taking on an established brief, but he is a new person in role and he will come with his own ideas, he will come with his own focus, he will want to look at a brief that he's picked up and think, where are the holes in this and where can I improve this? Is he listening? I I think it would be, I would be worried if he'd be listening in the first two days. I would expect him to be have his head in the brief and trying to understand something. But to anyone that's listening to this, that you should be advocating, you should be writing to your local MPs, but you should be making the representation directly to the Secretary of State if you're a association or a body representing an industry. This is the time, this is the goal now to be engaging with a with a new face on that and to put that case to them.
SPEAKER_01Well, thank you very much, Jenny. It's been a pleasure speaking to you, and uh your insight, I'm sure, will be very welcome to our listeners. Thank you very much. Thank you for having me.